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Right side weakness, POEMS disease. MRI taken. What are the findings?

MRI results - language. I have right side weakness for years and recently had a severe case of adhesive capsulitis . after that time I was receiving physical therapy and the weakness in the right arm became greater and numbness in lower three fingers as well as arm. MRI was suggested. Shoulder is doing better but still have right side weakness. To complicate this I have POEMS disease but I don't know how much of the symptoms are related to the disease - or not at all. So frustrated. I deal with chronic pain and muscle problems all the time. Now I am having problems in the lower left rib area with extreme pain. Ultrasound didn't reveal much - I have had an enlarged spleen for years but it showed no changes.
Anyway. Here are the results of the MRI of neck as related to the shoulder/arm problems.
Thank You,
AGE: 52 years DOB: 7/23/1960 GENDER: Female      


COMPARISON: MRI from 11/4/2010      

CLINICAL INDICATION: neck pain with radicular symtoms on the      
right arm..      

TECHNIQUE: Sagittal T1-weighted, sagittal T2-weighted, sagittal      
STIR, axial T2-weighted, axial gradient echo.      


Mild degenerative changes are present at C1-2.      

Vertebral bodies are normal in height, signal, and alignment.      

There is diffuse desiccation of the cervical discs.      

Ligaments are within normal limits.      

The spinal cord is normal in signal and size. Contour the spinal      
cord is abnormal at C5-6 and C6-7 due to central spinal stenosis      
from disc osteophyte complexes. These will be further described      
on the axial images.      

Axial images:      

C2-3: No significant abnormality      

C3-4: Broad-based disc osteophyte complex with resultant mild      
central spinal stenosis. There is right uncovertebral hypertrophy      
producing moderate right neural foraminal stenosis. There is left      
uncovertebral hypertrophy producing mild left neural foraminal      

C4-5: Broad-based disc osteophyte complex with resultant mild      
central spinal stenosis. There is mild left neural foraminal      
stenosis. Right neural foramen is normal.      

C5-6: Broad-based disc osteophyte complex with resultant severe      
central spinal stenosis and flattening of the spinal cord. There      
is severe bilateral neural foraminal stenosis due to      
uncovertebral hypertrophy. No definite cord signal abnormality.      

C6-7: Broad-based disc osteophyte complex. In addition, there is      
a small superimposed left paracentral protrusion that contacts      
the left hemicord but does not significantly efface it. There is      
resultant severe left neural foraminal stenosis as the lesser      
paracentral protrusion extends into the proximal aspect of the      
left neural foramen. There is moderate left hemi-canal stenosis.      
Right neural foramen is normal.      

C7-T1: No significant abnormality      

Paraspinal soft tissues are within normal limits.      

Flow-voids are present within the imaged aspects of the vertebral      
arteries, common carotid arteries, and internal carotid arteries.      


1. Multilevel degenerative changes as detailed above. No      
significant interval change from previous exam on 11/4/2010.      
2. At C5-6, there is a broad-based disc osteophyte complex      
producing severe central spinal stenosis and cord effacement.      
There is severe bilateral neural foraminal stenosis. There are no      
abnormal cord signal changes.      
3. At C6-7, there is a broad-based disc osteophyte complex and a      
small superimposed left paracentral protrusion extends into the      
proximal aspect of the left neural foramen. There is moderate      
left hemi-canal stenosis and severe left neural foraminal      
Electronically Signed by Arun Krishnan, MD, Sutter Medical Group      
3/20/2013 8: 13 PM      

Asked On : Fri, 29 Mar 2013
Answers:  1 Views:  63
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Question is related to
Radiologist 's  Response
May 2014
Interpreting you MRI neck (cervical spine) results:
1. Multilevel degenerative changes: There are degenerative changes noted at more than one level (C1-2, C3-4, C4-5, C5-6 and C6-7). There are 7 bones(vertebrae) in the cervical spine and numbered accordingly, C3-4 referring to the regions lower portion of C3 and upper part of C4. In your case there is no change from what was observed in MRI done on 11-04-2010.
2. In the C5-6 region broad based osteophyte complex refers to an age related owtgrowth arising from the vertebrae at that level. In your sace this is causing severe central spinal canal stenosis (external compression on the spinal cord at that level and also resulting in pressure on nerve roots that eit the region through holes on either side. Spinal cord is normal.
3. At C6-7 level also there is a broad based bony outgrowth with a causing little disc protrusion to left side with resulting pressure on the exiting nerve on the left side of severe grade with the spinal canal diameter being reduced at this level on its left side.

Final interpretation:
Weakness on your right side could be the result of nerve root compression at C5-6 level. Please report any similar problems on your left side immediately to your doctor, if you experience any.
Now you have to take into account your POEMS disease also when we talk about weakness. In POEMS disease there is polyneuropathy which is an important feature. Your weakness must be appropriately evaluated keeping in mind your neck changes and the fact that you also suffer from POEMS disease.
Take care
Answered: Fri, 7 Jun 2013
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